Academic Intelligence · Curated Daily

探索全球前沿学术脉络

AcademicHub 汇聚顶级期刊与预印本平台的实时文献。定制您的专属科研雷达,利用大语言模型自动生成交叉领域文献分析简报。

01.
medRxiv (Medicine) 2026-06-11

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

02.
arXiv (CS.LG) 2026-06-16

HRIR-Former: Grid-Free Time-Domain Reconstruction of Head-Related Impulse Responses with a Spatially Encoded Transformer

arXiv:2603.27998v2 Announce Type: replace-cross Abstract: Individualized head-related impulse responses (HRIRs) enable binaural rendering, but dense per-listener measurements are costly. We address HRIR spatial up-sampling from sparse per-listener measurements: given a few measured HRIRs for a listener, predict HRIRs at unmeasured target directions. Prior learning methods often work in the frequency domain, rely on minimum-phase assumptions or separate timing models, and use a fixed direction grid, which can degrade temporal fidelity and spatial continuity. We propose HRIR-Former, a time-domain, grid-free binaural Transformer for reconstructing HRIRs at arbitrary directions from sparse inputs. It uses sinusoidal spatial features, a Conv1D refinement module, and auxiliary interaural time difference (ITD) and interaural level difference (ILD) heads. On SONICOM, it improves normalized mean squared error (NMSE), cosine distance, and ITD/ILD errors over prior methods; ablations validate modules and show minimum-phase preprocessing is unnecessary.

03.
arXiv (CS.AI) 2026-06-18

NeSyCat Torch: A Differentiable Tensor Implementation of Categorical Semantics for Neurosymbolic Learning

arXiv:2606.19279v1 Announce Type: new Abstract: Neurosymbolic semantics is fragmented: classical, fuzzy, probabilistic and neural systems each define truth by their own inductive rules. NeSyCat, extending ULLER, subsumes them under a single inductive definition of truth, parametric in a strong monad and an aggregation structure on truth-values. NeSyCat has so far lacked an account of predicates and functions learned by neural networks. We provide NeSyCat Torch as the missing link and interpret computational symbols via neural networks, implementing the framework in probabilistic programming and tensor-based backends. We use the distribution monad for reference semantics and metric evaluation, and complement it by a monad for numerically stable, differentiable training: the lazy log-tensor monad over the log-semiring. For efficient training in batches, we furthermore employ a batch monad. The axioms are the source code: written once in monad-based do-notation, monadic bind performs marginalisation, lazily pruning unneeded branches. On MNIST addition, our HaskTorch, JAX, and PyTorch implementations outperform LTN and DeepProbLog in speed and accuracy, while achieving nearly the accuracy of DeepStochLog. However, unlike DeepStochLog, we stay in a uniform framework that applies to many first-order NeSy approaches. Namely, the construction is parametric in the monad; instantiating it with, e.g., the Giry monad extends the approach to continuous probability (working out a neural representation here is left for future work).

05.
Nature (Science) 2026-06-17

A distant brown dwarf coplanar to a warm Jupiter and a hot super-Earth

In transiting planetary systems, in which planetary sizes are accurately determined from transit observations, the presence of transit-timing variations1 (TTVs), especially when combined with radial velocity (RV) data, provides powerful constraints on masses and orbital eccentricities. Together, these measurements offer crucial insights into system architecture, formation mechanisms and dynamical evolution. We present long-term RV and transit/TTV monitoring of the relatively young star (age approximately 1 Gyr) TOI-201, revealing an exceptional multi-planet system composed of a hot super-Earth (SE) size planet transiting every 5.8 days, a warm Jupiter (WJ) on a 53-day orbit and an eccentric (e = 0.62) low-mass brown dwarf (BD) on an approximately 8-year orbit, with an estimated mass MBD of about 16 Jupiter masses. The BD is the longest-period transiting substellar object ever characterized by means of RVs and the only one known to be coplanar with inner planets. The architecture of this system suggests that the SE was formed isolated and in the innermost region of the gaseous disk. On the other hand, the orbital configuration of the outer companions suggests a nearly in situ formation of both objects, with the WJ forming in a dense inner disk. Alternatively, the BD might have formed farther out and migrated inward, while increasing its eccentricity owing to interactions with the disk. Analysis of long-term radial velocity data and transit time variations, induced by a super-Earth, a warm Jupiter and a brown dwarf in a coplanar orbit around the relatively young star TOI201.

06.
PLOS Computational Biology 2026-06-08

Statistics of cortical representational drift can enable robust readout

by Charles Micou, Timothy O’Leary Representational drift of fixed stimuli, learned tasks and familiar environments is observed in many brain areas, leading to reconfiguration of population codes over days to weeks. This raises the question of whether downstream brain regions employ mechanisms to track changes in population activity and thus preserve the fidelity of the information they extract. We show that the statistical properties of drift have a significant impact on such mechanisms. Over an extended period, a net change in population tuning due to drift can arise from an accumulation of small changes distributed across the population, or via abrupt jumps that affect smaller subsets of cells at each time point. We demonstrate that an adaptive readout can exploit the heavy-tailed statistics of abrupt jumps to maintain a more stable readout using a simple inference mechanism. Using experimental data, we investigate the extent to which heavy-tailed drift statistics are observed during representational drift in the posterior parietal cortex and visual cortex. We find that experimentally measured drift does not conform to a Gaussian random walk. Instead, we find sudden jumps in neural tuning that would be advantageous for a downstream observer adapting to changes in representation. These observations motivate future study to determine whether adaptive decoding mechanisms exist in the brain and to determine the physiological mechanisms that shape the statistics of representational drift.

07.
arXiv (CS.CV) 2026-06-16

X-Tokenizer: A Multimodal Action Tokenizer for Vision-Language-Action Pretraining

Modern Vision-Language-Action (VLA) models must bridge pretrained vision-language reasoning and precise continuous robot control. Existing action tokenizers discretize actions primarily for reconstruction, producing codes that preserve motion geometry but provide only weak semantic supervision to the backbone. We therefore formulate action tokenization not as mere compression, but as semantic interface learning between multimodal reasoning and executable control. To this end, we introduce X-Tokenizer, a lightweight encoder-Semantic Residual Quantization (SRQ)-decoder architecture that provides a shared action interface across diverse robotic arm embodiments. Its key component, SRQ, imposes an asymmetric structure on residual vector quantization: the first level is trained with Masked Action Modeling (MAM) to form a discrete action language that captures coarse motion intent, while deeper levels remain reconstruction-oriented residuals that preserve fine-grained details. To further align action tokens with multimodal semantics, X-Tokenizer is pretrained with contrastive alignment to the representation space of a pretrained foundation model and with next-frame vision-language feature prediction. Pretrained on 2.4M trajectories (2.0B action frames), a single frozen X-Tokenizer plugs into a mixed discrete-continuous VLA as a representation-shaping supervision signal. X-Tokenizer achieves top real-world aggregate and strong RoboTwin 2.0 simulation results. Outperforming FAST in multimodal grounding (+13.5%) and long-horizon tasks (+8.25), it shows that action tokenizers serve as semantic interfaces for VLA pretraining beyond mere action compression.

08.
arXiv (CS.CL) 2026-06-16

Know Your Limits : On the Faithfulness of LLMs as Solvers and Autoformalizers in Legal Reasoning

Large Language Models (LLMs) achieve strong performance on reasoning tasks, but whether this reflects faithful logical inference or heuristic approximation remains unclear. We study this question in legal entailment by comparing three paradigms, including pure LLM classification, LLM-based Formal Reasoning, and solver-based Formal Reasoning using the Z3 SMT solver, on a re-annotated subset of ContractNLI across five LLMs. Our re-annotation reveals a systematic and measurable gap between pragmatic legal interpretation and strict formal entailment, where a substantial proportion of legally sound inferences are not formally grounded without additional unstated assumptions. While introducing formal structure improves accuracy, with LLM-based Formal Reasoning achieving the highest benchmark performance, we show that this gain does not imply faithful reasoning. We identify three recurring failure modes: scope laundering, where LLMs report solver-inconsistent classifications without executing the underlying formal reasoning, producing conclusions that appear logically grounded but are not; implicit constraint blindness, where LLMs overlook logical constraints present in formal representations; and program synthesis failures, where LLMs generate incorrect Z3 code despite structured prompting. Critically, scope laundering persists across all models, raising serious concerns about the faithfulness of LLM-based formal reasoning as a proxy for symbolic execution. These results reveal a fundamental gap between benchmark accuracy and logical faithfulness.

09.
arXiv (math.PR) 2026-06-11

Construction of ergodic IDLA forests in $\mathbb{Z}^d$

arXiv:2506.10476v2 Announce Type: replace Abstract: We prove the existence of infinite-volume IDLA forests in $\mathbb{Z}^d$ , with $d \geq 2$, based on a multi-source IDLA protocol. Unlike IDLA aggregates, the laws of the IDLA forests studied here depend on the trajectories of particles, and then do not satisfy the famous Abelian property. Their existence is due to a stabilization result (Theorem 1.1, our main result) that we establish using percolation tools. Although the sources are infinitely many, we also prove that each of them play the same role in the building procedure, which results in an ergodicity property for the IDLA forests (Theorem 1.2).

10.
arXiv (CS.LG) 2026-06-24

Subtyping patients with chronic disease using longitudinal BMI patterns

arXiv:2111.05385v3 Announce Type: replace Abstract: Obesity is a major health problem, increasing the risk of various major chronic diseases, such as diabetes, cancer, and stroke. While the role of obesity identified by cross-sectional BMI recordings has been heavily studied, the role of BMI trajectories is much less explored. In this study, we use a machine-learning approach to subtype individuals' risk of developing 18 major chronic diseases by using their BMI trajectories extracted from a large and geographically diverse EHR dataset capturing the health status of around two million individuals for a period of six years. We define nine new interpretable and evidence-based variables based on the BMI trajectories to cluster the patients into subgroups using the k-means clustering method. We thoroughly review each cluster's characteristics in terms of demographic, socioeconomic, and physiological measurement variables to specify the distinct properties of the patients in the clusters. In our experiments, the direct relationship of obesity with diabetes, hypertension, Alzheimer's, and dementia has been re-established and distinct clusters with specific characteristics for several of the chronic diseases have been found to be conforming or complementary to the existing body of knowledge.

11.
arXiv (quant-ph) 2026-06-16

Enhanced Sensitivity near a Quantum Exceptional Point in the Absence of Engineered Dissipation

arXiv:2606.16060v1 Announce Type: new Abstract: Non-Hermitian systems exhibit phenomena absent from Hermitian systems, including exceptional points (EPs), at which two or more eigenvectors coalesce. Conventional implementations rely on gain and loss, which strongly limit quantum coherence. Here, following a proposal by Wang and Clerk (PRA 2019), we realize a closed four-mode quantum system that emulates the dynamics of a PT dimer - two coupled resonators with balanced gain and loss - without engineered dissipation. The four modes are implemented as harmonics of a superconducting coplanar-waveguide resonator, with parametric couplings engineered using a current-pumped SNAIL. We use this device as a sensor for small variations in the PT dimer coupling strength. From signal-to-noise-ratio measurements, we observe enhanced sensitivity near the EP in a non-quantum-limited regime.

12.
arXiv (math.PR) 2026-06-11

Percolation on hierarchical lattices

arXiv:2606.11503v1 Announce Type: new Abstract: We consider independent Bernoulli percolation on top of sequences of hierarchical graphs. Given a graph $G_{1}$ with two distinguished vertices $a_{1}$ and $b_{1}$, the hierarchical graph with seed $G_{1}$ is the sequence $\big( G_{k} \big)_{k \geq 1}$ resulting from the inductive procedure, where the graph $G_{k+1}$ is obtained from $G_{k}$ by replacing each of its edges with a copy of $G_{1}$, attached by the vertices $a_{1}$ and $b_{1}$. We prove that, under sharp hypotheses, percolation on these graphs presents a unique phase transition. Second, we establish the existence of several critical exponents in this context, such as the critical exponents for the correlation length $\nu$, the surface tension $\mu$, the one-arm exponent $\alpha_{1}$. Several results are also obtained for their infinite counterpart $G_\infty$, which is the Benjamini-Schramm limit of $G_k$: uniqueness of the infinite cluster, continuity of $\theta(p)$, existence of the percolation-probability exponent $\beta$ and scaling relations for the critical exponents $\alpha_1$, $\nu$ and $\beta$. Furthermore, we analyze noise sensitivity for crossing functions in $G_{k}$ and establish sharp noise sensitivity in this setting. Finally, we propose a setup where it is possible to verify the locality hypothesis, stating that the critical threshold for percolation is a local property, while critical exponents are determined by the global geometry of the graph. As a consequence of the techniques developed here, we also provide a necessary and sufficient condition for the existence of a unique fixed point for the map $p \mapsto \mathbb{E}_p[g]$ in $(0,1)$, where $g:\{0,1\}^n \to \{0,1\}$ is a nontrivial monotone Boolean function.

13.
arXiv (quant-ph) 2026-06-16

Intermodal entanglement in a quantum optical model of HHG due to the back-action on the driving field

arXiv:2603.01315v2 Announce Type: replace Abstract: Preparation of nonclassical light with special quantum properties is essential for quantum technologies. High-harmonic generation (HHG) is a process which not only enables the creation of attosecond pulses but also has the potential to generate light with intricate quantum properties. In a recent experiment [1], nonclassical inter-harmonic correlations have been measured from a HHG source. In this work, we theoretically investigate entanglement between different harmonics within an effective quantum optical model. This model implements a signifcant degree of simplifcation regarding the processes within the target material, treating the material through susceptibilities, as it is usual in quantum optics. Such an approach yields a general description of HHG, permitting the implications that can be derived within it to hold broadly. We find that entanglement is produced as a result of the often neglected back-action. We can qualitatively reproduce experimentally measured nonclassicalities, which suggests that intermodal entanglement can, to an extent, be considered a universal phenomenon associated with HHG, rather than a result of using specific material targets.

15.
bioRxiv (Bioinfo) 2026-06-19

Accurate detection of tumor clonality and ongoing expansion mode from genomic data

Recent evidence shows that despite considerable effort, currently available algorithms for estimating intra-tumor heterogeneity (ITH) remain limited. We developed DECODE (Deciphering Cancer Origin from DNA Evolution), a novel mutation clustering method that incorporates the impact of sample-specific sequencing coverage and mutation calling biases. On synthetic data, DECODE outperformed existing methods across multiple clonality metrics and accurately detected and characterized the neutral tail in the site frequency spectrum (SFS), which encodes the tumor's ongoing expansion mode. In acute myeloid leukemia, accounting for the neutral tail enabled DECODE to yield more parsimonious clonal decompositions that align more closely with known subclonal dynamics that drive relapse. Applied to data from The Cancer Genome Atlas, DECODE not only detected a neutral SFS tail in most samples across tumor types but also uncovered a clinically meaningful link between ITH and survival in low-grade glioma. By jointly inferring clonality and expansion mode, DECODE provides two complementary and prognostically relevant readouts of tumor evolution from single tumor genomic samples.

16.
arXiv (CS.LG) 2026-06-19

Folded Transport MCMC: Eliminating Label Switching by Sampling on a Fundamental Domain

作者:

arXiv:2606.04307v2 Announce Type: replace Abstract: In Bayesian mixture models and other exchangeable-component models, the posterior is invariant under permutation of component labels, creating m! equivalent modes-the label-switching problem. Standard MCMC methods either mix poorly across these modes or rely on post-hoc relabelling that cannot guarantee the sampler has converged. We propose Folded Transport MCMC (FolT-MCMC), which eliminates label switching before sampling by restricting the Markov chain to a fundamental domain-a sorted or reflected subspace containing exactly one representative from each symmetric mode. The proposal is a learned normalising flow whose density is symmetrised over the group orbits, ensuring correct targeting on the reduced space. We show that this construction preserves a computable convergence diagnostic based on the oscillation of the log-density ratio, and that the diagnostic becomes sharper on the fundamental domain whenever the original-space flow under-covers one or more symmetric modes. Experiments on Gaussian mixtures (d=2-20), label-switching targets (up to 24 equivalent modes), a standard Bayesian three-component mixture posterior, and real accelerometer data from a supertall building show improvement ratios of 2x to 145x, with the folded diagnostic stable across dimensions while the unfolded diagnostic collapses.

17.
arXiv (quant-ph) 2026-06-19

Spatial Localization of Relativistic Quantum Systems: The Commutativity Requirement and the Locality Principle. Part II: A Model from Local QFT

arXiv:2604.04173v3 Announce Type: replace-cross Abstract: This paper is the second and final part of a two-part study. We construct positive-energy relativistic spatial localization observables in Minkowski spacetime within standard quantum field theory, using the stress–energy–momentum tensor smeared with suitable test functions. For each fixed timelike direction, the construction gives positive operator-valued measures (POVMs) on spacelike hypersurfaces, well defined on every $n$-particle sector and satisfying a relativistic causality condition excluding superluminal propagation of detection probabilities. The observables are built from local or quasi-local field-theoretic quantities, thus providing a rigorous version of earlier heuristic proposals. In the one-particle sector, the construction reduces to the observable previously introduced by the author, and its first moment gives the Newton–Wigner position operator under appropriate normalization and centering assumptions. Because the Reeh–Schlieder theorem prevents the normally ordered stress–energy–momentum tensor from being positive on the full Fock space, we use quantum energy inequalities to obtain lower bounds controlling deviations from positivity. This leads to regularized operator families, bounded from below, which approximate the localization effects. Finally, we define conditional localization observables for finite laboratories through modified local energy operators. By Haag duality, the corresponding conditional POVMs belong to local von Neumann algebras and commute for causally separated regions, in accordance with the Araki–Haag–Kastler framework. The results show how commutativity of localization observables is recovered for conditional measurements in finite spacetime regions.

18.
arXiv (quant-ph) 2026-06-16

Exactly Solvable Quantum Model with Spin-Dependent Coulomb Interaction

arXiv:2501.05103v5 Announce Type: replace Abstract: In this work, we report an exactly solvable quantum model featuring a spin-dependent Coulomb interaction, described by the spin vector potential \(\vec{\mathcal{A}} = k (\vec{r} \times \vec{S}) / r^2\) together with a Coulomb-type scalar potential \(\varphi = \kappa / r\) . The model is governed by the Schrödinger-type Hamiltonian \(\mathcal{H}_S = \vec{\Pi}^2 / (2M) + q \varphi\) in nonrelativistic quantum mechanics and by the Dirac-type Hamiltonian \(\mathcal{H}_D = c \vec{\alpha} \cdot \vec{\Pi} + \beta M c^2 + q \varphi\) in relativistic quantum mechanics, where \(\vec{\Pi} = \vec{p} - (q/c)\vec{\mathcal{A}}\) is the canonical momentum. We demonstrate two main results: (i) Just as the Coulomb-type scalar potential \(\mathcal{S}_Maxwell = \{\vec{\mathcal{A}} = 0,\ \varphi = \kappa / r\}\) is a local exact solution of Maxwell's equations on $r\neq0$, the gauge potential \(\mathcal{S}_YM = \{\vec{\mathcal{A}} = k (\vec{r} \times \vec{S}) / r^2,\ \varphi = \kappa / r\}\) constitutes a local exact solution of the Yang–Mills equations on the punctured region $r\neq0$. (ii) Both Hamiltonians \(\mathcal{H}_S\) and \(\mathcal{H}_D\) can be solved exactly in the presence of this spin-dependent Coulomb interaction. The resulting energy spectra are derived, and they naturally reduce to those of the ordinary hydrogen atom when the spin-dependent terms are neglected. Finally, we clarify the quantization conditions and the fixed-background interpretation of the model.

19.
arXiv (quant-ph) 2026-06-17

The Standard Model, The Exceptional Jordan Algebra, and Triality

作者:

arXiv:2006.16265v2 Announce Type: replace-cross Abstract: Jordan, Wigner and von Neumann classified the possible algebras of quantum mechanical observables, and found they fell into 4 "ordinary" families, plus one remarkable outlier: the exceptional Jordan algebra. We point out an intriguing relationship between the complexification of this algebra and the standard model of particle physics, its minimal left-right-symmetric $SU(3)\times SU(2)_{L}\times SU(2)_{R}\times U(1)$ extension, and $Spin(10)$ unification. This suggests a geometric interpretation, where a single generation of standard model fermions is described by the tangent space $(\mathbb{C}\otimes\mathbb{O})^{2}$ of the complex octonionic projective plane, and the existence of three generations is related to $SO(8)$ triality.

20.
arXiv (quant-ph) 2026-06-24

Dimensionality Reduction of QAOA Parameter Space with Kernel PCA for Max-Cut

arXiv:2606.23718v1 Announce Type: new Abstract: The Quantum Approximate Optimization Algorithm (QAOA) is a leading variational algorithm for combinatorial optimization on near term quantum devices. As circuit depth increases, the number of optimization parameters grows, making the search landscape increasingly nonlinear and difficult to optimize. Previous studies have shown that optimal QAOA parameters often lie on a low dimensional manifold that can be approximated using Principal Component Analysis (PCA) at shallow circuit depths. However, the effectiveness of PCA decreases at higher depths because the underlying parameter manifold becomes increasingly nonlinear. In this work, we investigate Kernel Principal Component Analysis (KPCA) with a radial basis function kernel as a nonlinear dimensionality reduction technique for QAOA parameter optimization. The model is trained using 200 graphs from each of 3 graph families, namely Erdos-Renyi, Barabasi-Albert, and Watts-Strogatz, with graph sizes ranging from 7 to 10 nodes. Performance is evaluated on 30 test graphs containing 12 nodes at circuit depths 1, 2, 4, and 8. Experimental results demonstrate that KPCA consistently outperforms PCA at deeper circuit depths across all graph families. At depth 8, KPCA achieves approximation ratios above 0.86, while PCA declines to approximately 0.81 to 0.83. Both methods reduce the number of quantum circuit evaluations by more than 93 percent relative to unrestricted QAOA optimization. These findings suggest that nonlinear kernel methods more effectively capture the structure of the QAOA parameter manifold and provide a practical approach for scaling variational quantum optimization to deeper circuits.

21.
arXiv (CS.CV) 2026-06-11

FreqKD: Frequency-Decoupled Cross-Modal Knowledge Distillation for Infrared Object Detection

Transfer learning from large-scale RGB foundation models to infrared (IR) imagery through knowledge distillation (KD) remains challenging due to fundamental differences in image formation physics. We investigate the spectral structure of the RGB–IR modality gap and observe that feature divergence is not uniform across spatial frequencies: low-frequency components (shape, layout) show greater cross-modal alignment than high-frequency components (texture, fine edges), which reflect modality-specific characteristics. Based on this analysis, we propose FreqKD, a frequency-decoupled distillation framework that applies asymmetric supervision adapted to each band's cross-modal consistency. The method employs strict mean squared error (MSE) on the low-frequency band to preserve shared structural information and a relaxed log-MSE loss (weighted at 0.1) on the high-frequency band to provide edge guidance while tolerating texture differences. Spectral divergence analysis on 500 paired samples shows that high-frequency divergence exceeds low-frequency divergence by a factor of 2.4x on average across all analysed transformer layers. On KAIST multispectral pedestrian detection, FreqKD achieves 64.1 mAP50, improving 2.4 points over the DINOv2 baseline. The learned representation transfers across datasets (FLIR ADAS, +2.1 mAP50), tasks (MFNet segmentation, +1.85 mean intersection-over-union), and architectures (ResNet-50, +1.0 mAP50). Code is available at: https://anonymous.4open.science/r/freq_decoupled_kd-5E5A

22.
PLOS Medicine 2026-05-29

Availability, appeal, and addictiveness by design: Tobacco and nicotine industry deliberate targeting of youth

by Raglan Maddox, Becky Freeman, Charlotta Pisinger, Emily Banks Contemporary tobacco and nicotine products, particularly e-cigarettes, are deliberately designed, marketed, and distributed to maximize youth appeal, uptake, dependence, and use. Youth uptake is a predictable outcome of systems designed to maximize product availability, appeal, and addictiveness. In recognition of the World No Tobacco Day 2026 theme, "unmasking the appeal", this Perspective by Raglan Maddox and colleagues discusses how tobacco and nicotine products, particularly e-cigarettes, are deliberately designed and marketed to maximize youth appeal, and highlight the need for policies to ensure greater industry accountability and to tackle concerning uptake trends.

23.
medRxiv (Medicine) 2026-06-12

Integrative Mechanisms of Early Clinical and Research Training (ECART) in Orthopaedic Medical Education: A Qualitative Single-Case Study

Background: Early clinical exposure and student participation in research are important components of medical training. They may support learning motivation, evidence literacy, and self-directed learning. In many programmes, however, clinical training and research training remain separated. Few studies have explained, within a real teaching team, how learners turn clinical phenomena into researchable questions and how research participation can reshape their clinical understanding. Early Clinical and Research Training (ECART) is a clinical-research integration approach developed by an orthopaedic team at the Second Hospital of Shandong University. Methods: We conducted a theory-informed, interpretivist qualitative single-case study. The case was an orthopaedic clinical-research team at the Second Hospital of Shandong University. Participants included medical undergraduates, academic degree graduate students, professional degree graduate students, clinical teachers, and research platform leads. We used purposive sampling with maximum variation. Data were collected through semi-structured interviews and de-identified teaching documents. Data were analysed using the framework method and were interpreted with a Context-Activity-Mechanism-Outcome (CAMO) logic. Results: The analysis showed that ECART was not simply early entry into the clinic or early entry into the laboratory. It was a team-based learning process centred on real medical problems. Four themes were identified. First, early clinical exposure helped learners make real problems visible and nameable, rather than merely increasing exposure. Second, clinical-research connection followed different pathways. Professional degree graduate students often started from clinical uncertainties in residency training and case management, and moved toward evidence-informed small projects. Academic degree graduate students often started from literature gaps, experimental findings, and mechanistic hypotheses, and then used clinical feedback to calibrate meaning. Third, research training, through literature reading, group meetings, experimental design, data review, and mentor questioning, helped learners move from completing tasks to explaining problems. Fourth, sustained ECART depended on a tiered team ecology formed by clinical teachers, research mentors, research platforms, and senior peers. Based on these findings, we refined the ECART programme theory: real medical problems are translated through explanation, searching, experimentalisation, and feedback-based reinterpretation into research questions that learners can understand, discuss, and test. This process supports problem formation, evidence awareness, mechanistic reasoning, translational judgement, and career clarification. Conclusion: ECART is best understood as a clinical-research integrated learning ecology that emerges from real team practice, rather than as a fixed standardised course. Its educational value lies in a recurring cycle of real problems, research translation, multi-source feedback, and clinical reinterpretation. This framework may inform the design, evaluation, and contextual adaptation of clinical-research integration pathways in medical education.

24.
medRxiv (Medicine) 2026-06-15

Beyond the Apnea-Hypopnea Index: Physiological and Demographic Predictors of Excessive Daytime Sleepiness in Obstructive Sleep Apnea

Excessive daytime sleepiness (EDS) is a common but inconsistently predicted symptom of obstructive sleep apnea (OSA). OSA is typically diagnosed with polysomnography (PSG), and the current standard for severity assessment is the apnea-hypopnea index (AHI). AHI has many limitations, including its inability to explain physiological mechanisms or reflect variability in patient symptoms, such as EDS. This retrospective study aims to find physiological and demographic parameters that better predict EDS in patients with OSA and to evaluate whether these parameters outperform AHI using PSG data from the Mount Sinai Integrative Sleep Center. Clinical variables used to predict EDS included arousal index (AI), average oxygen desaturation during sleep, average heart rate during sleep, and AHI, along with demographic variables including age, sex, and BMI. Hypothesis tests, logistic regression models, and decision tree classifier models were performed on the data to discriminate sleepy from nonsleepy patients as determined by an Epworth Sleepiness Scale (ESS) score [≥] 10. AI and oxygen desaturation were found to be the most predictive physiological variables, and sex and BMI were found to be the most predictive demographic variables. The final decision tree model with these four variables outperformed the AHI in predicting EDS. These findings suggest that daytime sleepiness in OSA can be better explained by measures of apnea burden, oxygenation impairment, and patient demographics than by AHI alone, although these remain only modestly predictive. Future studies should focus on investigating more comprehensive physiological markers, multi-night sleep data, and more objective assessments of sleepiness.

25.
arXiv (CS.LG) 2026-06-12

The Mathematics of AI Winters: The mathematical Taxonomy of Paradigm Fragility in AI Winter

arXiv:2606.12610v1 Announce Type: new Abstract: Two major periods of reduced funding and confidence in artificial intelligence research, commonly called the first and second AI winters, are usually explained through engineering failure, commercial disappointment, and inflated expectations. This article develops a complementary thesis: that the dominant paradigms of those periods also met genuine formal barriers, including limitations of representation, optimisation, computational complexity, statistical learnability, and high-dimensional approximation. The contribution is synthetic rather than archival. We do not claim that particular theorems mechanically caused the winters; rather, we show that several central disappointments of early AI were aligned with mathematically precise bottlenecks. We analyse these bottlenecks through the perceptron impossibility results of Minsky and Papert, the complexity-theoretic hardness of exact neural-network training established by Blum and Rivest, minimax rates for nonparametric estimation in high dimension due to Stone, vanishing-gradient analyses by Hochreiter and by Bengio and collaborators, and classical statistical learning theory in the tradition of Vapnik and Chervonenkis, Valiant, and Blumer and collaborators. We then relate these barriers to the later breakthroughs that mitigated, rather than eliminated, them.